Subscribe to RSS
DOI: 10.1055/s-0041-1740067
Ophthalmic Microsurgery Lab for Medical Students: Enhancing Learner Intrinsic Motivation and Comfort with Microsurgery
Funding This work was supported in part by a Research to Prevent Blindness unrestricted grant to the Department of Ophthalmology, University of California San Francisco. The Funding source had no involvement in the study design, collection, analysis, data interpretation, manuscript writing, or decision to publish.Abstract
Objective This study aimed to evaluate the impact of an ophthalmic microsurgery laboratory on medical students' intrinsic motivation, explicit interest in ophthalmology, and comfort with microsurgical skills.
Design In this noncontrolled trial, medical students attended a Zoom-based lecture on corneal suturing, watched an instructional video on operating microscopes, and attended a wet laboratory on corneal suturing. Participants completed pre- and posttest surveys assessing comfort with microsurgical skills and explicit interest in ophthalmology. Additionally, the posttest survey included items from the Intrinsic Motivation Inventory (IMI).
Setting This study was conducted at a single academic medical center.
Participants A total of 20 students enrolled in the MD program at the University of California, San Francisco School of Medicine.
Results Pre- and posttest response rates were 100% (n = 20) and 90% (n = 18), respectively. Comfort with microsurgical skills increased significantly between pre- and posttest surveys with large effect sizes (95% confidence interval [CI]; p-value): loading a needle, 1.67 (1.04–2.29; p < 0.001); passing a suture, 1.72 (1.04–2.40; p < 0.001); knot tying, 1.05 (0.34–1.76; p = 0.004); using a microscope, 0.83 (0.04–1.63; p = 0.040); and suturing under a microscope, 1.44 (0.88–2.00; p < 0.001). Comparing pre- and posttest surveys, students reporting moderate to extreme interest in ophthalmology increased from 44 to 61%. Intrinsic motivation was high, indicated by the mean IMI Interest score reaching 93% of the maximum score. Multiple linear regression analyses predicted that IMI Interest scores increased with higher scores of familiarity (p = 0.002), explicit interest in ophthalmology (p = 0.042), and comfort with microscopes (p = 0.005), knot tying (p = 0.026), and performing surgical maneuvers under a microscope (p = 0.032).
Conclusion Ophthalmic microsurgery laboratories may increase medical students' explicit interest in ophthalmology, comfort with microsurgical skills, and intrinsic motivation. Future studies are needed to evaluate the impact of microsurgical electives on students' objective skills and specialty selection.
Keywords
undergraduate medical education - ophthalmology - microsurgery - motivation - surgical simulationCompetencies
Patient Care and Procedural Skills, Medical Knowledge.
Publication History
Received: 13 April 2021
Accepted: 19 August 2021
Article published online:
11 December 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. National and Regional Projections of Supply and Demand for Surgical Specialty Practitioners: 2013–2025. Accessed September 2, 2021 at: https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/surgical-specialty-report.pdf
- 2 Xierali IM, Nivet MA, Wilson MR. Current and future status of diversity in ophthalmologist workforce. JAMA Ophthalmol 2016; 134 (09) 1016-1023
- 3 Linz MO, Jun AS, Clever SL, Lawson SM, Sanyal A, Scott AW. Evaluation of medical students' perception of an ophthalmology career. Ophthalmology 2018; 125 (03) 461-462
- 4 Shah M, Knoch D, Waxman E. The state of ophthalmology medical student education in the United States and Canada, 2012 through 2013. Ophthalmology 2014; 121 (06) 1160-1163
- 5 Moxon NR, Goyal A, Giaconi JA. et al. The state of ophthalmology medical student education in the United States: an update. Ophthalmology 2020; 127 (11) 1451-1453
- 6 Seo HS, Eom YH, Kim MK, Kim Y-M, Song BJ, Song KY. A one-day surgical-skill training course for medical students' improved surgical skills and increased interest in surgery as a career. BMC Med Educ 2017; 17 (01) 265
- 7 Lee JT, Son JH, Chandra V, Lilo E, Dalman RL. Long-term impact of a preclinical endovascular skills course on medical student career choices. J Vasc Surg 2011; 54 (04) 1193-1200
- 8 Khatib M, Soukup B, Boughton O, Amin K, Davis CR, Evans DM. Plastic surgery undergraduate training: how a single local event can inspire and educate medical students. Ann Plast Surg 2015; 75 (02) 208-212
- 9 Lee JT, Qiu M, Teshome M, Raghavan SS, Tedesco MM, Dalman RL. The utility of endovascular simulation to improve technical performance and stimulate continued interest of preclinical medical students in vascular surgery. J Surg Educ 2009; 66 (06) 367-373
- 10 Drosdeck J, Carraro E, Arnold M. et al. Porcine wet lab improves surgical skills in third year medical students. J Surg Res 2013; 184 (01) 19-25
- 11 Sideris M, Papalois A, Theodoraki K. et al. Promoting undergraduate surgical education: current evidence and students' views on ESMSC international wet lab course. J Invest Surg 2017; 30 (02) 71-77
- 12 Müller A, Pfeiffer N, Schmidt F, Prokosch V. A microsurgical wet lab for medical students increases interest in ophthalmology [in German]. Ophthalmologe 2020; 117 (11) 1087-1091
- 13 Enders C, Schneider A, Keis O. et al. Innovative teaching methods: wet lab-based ophthalmosurgical education for medical students [in German]. Klin Monatsbl Augenheilkd 2019; 236 (07) 911-918
- 14 Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Accessed September 2, 2021 at: https://selfdeterminationtheory.org/SDT/documents/2000_RyanDeci_SDT.pdf
- 15 Intrinsic Motivation Inventory (IMI) – selfdeterminationtheory.org. Accessed March 31, 2021 at: https://selfdeterminationtheory.org/intrinsic-motivation-inventory/
- 16 Ryan RM. Control and information in the intrapersonal sphere: An extension of cognitive evaluation theory. J Pers Soc Psychol 1982; 43 (03) 450-461
- 17 Ostrow K, Heffernan N. Testing the validity and reliability of intrinsic motivation inventory subscales within ASSISTments. In: Rosé CP, Martínez-Maldonado R, Hoppe HU. et al, eds. Artificial Intelligence in Education. London, United Kingdom: 19th International Conference, AIED 2018; 2018: 381-394
- 18 Orsini C, Evans P, Jerez O. How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory. J Educ Eval Health Prof 2015; 12: 8
- 19 Monteiro V, Mata L, Peixoto F, Monteiro V, Mata L, Peixoto F. Intrinsic motivation inventory: psychometric properties in the context of first language and mathematics learning. Psicol Reflex Crit 2015; 28 (03) 434-443
- 20 Deci EL, Eghrari H, Patrick BC, Leone DR. Facilitating internalization: the self-determination theory perspective. J Pers 1994; 62 (01) 119-142
- 21 Plant RW, Ryan RM. Intrinsic motivation and the effects of self-consciousness, self-awareness, and ego-involvement: an investigation of internally controlling styles. J Pers 1985; 53 (03) 435-449
- 22 Williams GC, Saizow R, Ross L, Deci EL. Motivation underlying career choice for internal medicine and surgery. Soc Sci Med 1997; 45 (11) 1705-1713
- 23 Nibourg LM, Wanders W, Cornelissen FW, Koopmans SA. Influence of stereoscopic vision on task performance with an operating microscope. J Cataract Refract Surg 2015; 41 (09) 1919-1925
- 24 Binenbaum G, Volpe NJ. Ophthalmology resident surgical competency: a national survey. Ophthalmology 2006; 113 (07) 1237-1244
- 25 Ten Cate TJ, Kusurkar RA, Williams GC. How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide no. 59. Med Teach 2011; 33 (12) 961-973
- 26 Williams GC, Wiener MW, Markakis KM, Reeve J, Deci EL. Medical students' motivation for internal medicine. J Gen Intern Med 1994; 9 (06) 327-333
- 27 Deci EL, Ryan RM. Facilitating optimal motivation and psychological well-being across life's domains. Can Psychol Can 2008; 49 (01) 14
- 28 Kusurkar RA, Croiset G, Galindo-Garré F, Ten Cate O. Motivational profiles of medical students: association with study effort, academic performance and exhaustion. BMC Med Educ 2013; 13: 87
- 29 Kusurkar RA, Ten Cate TJ, van Asperen M, Croiset G. Motivation as an independent and a dependent variable in medical education: a review of the literature. Med Teach 2011; 33 (05) e242-e262
- 30 Covington MV. Goal theory, motivation, and school achievement: an integrative review. Annu Rev Psychol 2000; 51: 171-200
- 31 Walker CO, Greene BA, Mansell RA. Identification with academics, intrinsic/extrinsic motivation, and self-efficacy as predictors of cognitive engagement. Learn Individ Differ 2006; 16 (01) 1-12
- 32 Scholz M, Mücke T, Hölzle F. et al. A program of microsurgical training for young medical students: are younger students better?. Microsurgery 2006; 26 (06) 450-455
- 33 Mücke T, Borgmann A, Ritschl LM, Kesting MR, Loeffelbein DJ, Wolff K-D. Microvascular training of medical students and surgeons - a comparative prospective study. J Craniomaxillofac Surg 2013; 41 (08) e187-e190